Alexian Brothers Hospice Frequently Asked Questions
What is hospice?
Hospice is a system of care for patients with a terminal illness who have a life expectancy of six months or less and who choose not to seek (or to discontinue) treatment to cure the illness. The goal of hospice care is to make the patient as comfortable as possible, and to support the patient and family, emotionally and spiritually, during the final months of life. Hospice care does not provide curative treatment for the terminal condition, but offers palliative care, which gives relief from pain and other symptoms. This care is often provided in the patient’s private residence, but may also be provided in a hospital, assisted living facility, nursing home, or specialized inpatient hospice facility
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What services does hospice provide?
Hospice care is a family-centered approach that includes, at a minimum, a team of doctors, nurses, social workers, chaplains, bereavement counselors, and trained volunteers. They work collaboratively focusing on the patient’s needs, be they physical, psychological, or spiritual. The goal is to help keep the patient as pain-free and lucid as possible, with loved ones nearby until death.
Below is a list of services available to Medicare hospice recipients:
- Physician oversight for the medical direction of the patient’s care and home visits as needed
- Regular home visits by registered nurses and licensed practical nurses
- Hospice aides for hand-on personal care services such as dressing and bathing
- Social work and counseling
- Chaplains for spiritual support
- Specialized palliative care as needed to control pain and symptoms, i.e., physical therapy, palliative radiation treatment, etc.
- Dietary counseling
- Volunteer support to assist patients and loved ones
- Bereavement counseling and support for families
- All medications for symptom control and pain relief
- Medical supplies such as bandages and catheters
- Medical equipment such as hospital beds and oxygen
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Who pays for hospice care?
Medicare Part A provides a hospice benefit that pays for 100% of all the services, medications and equipment hospice provides. There is no out of pocket cost to patients for hospice. Medicaid and most private insurance plans also include benefits for hospice care.
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What does the hospice admission process involve?
Based on the physician authorization, the patient will be asked to sign consent and insurance forms. These are similar to the forms patients sign when they enter a hospital. The Medicare hospice election form says that the patient understands that the care is palliative (that is, aimed at pain relief and symptom control) rather than curative.
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Where does hospice care take place?
Hospice is provided wherever the patient lives. The majority of hospice patients are cared for in their own homes or the homes of a loved one. “Home” may also be nursing homes, hospitals, and other health care facilities.
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Must someone be with the patient at all times?
In the early weeks of care, it is usually not necessary for someone to be with the patient all the time. Later, however, as the patient’s needs change and to insure the patient’s comfort and safety, hospice works with the patient and family to see that the patient is not left alone.
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Does hospice do anything to hasten death?
Hospice does nothing either to hasten or to postpone the dying process. Hospice rejects the practice of assisted suicide or euthanasia in the care of the terminally ill. Just as doctors and midwives lend support and expertise during the time of childbirth, so hospice provides its presence and specialized knowledge during the dying process.
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If I’m on hospice, can I still see my doctor? Can I still receive treatment for other conditions?
The choice to receive hospice care does not replace your relationship with your doctor. Hospice works directly with the patient’s primary physician and encourages patients to continue to see their doctor as they wish. Under Medicare patients receive all treatment for the illness for which they were admitted to hospice from their doctor and the hospice team. Patients are free to continue treatments for other medical conditions, and still use their Medicare benefits.
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Will medications make my loved one groggy or too sleepy?
It is the goal of hospice to allow the patient to be pain free but alert. This can be a delicate balance depending on the condition of the patient. But, by constantly consulting with the patient, the family and the physicians, hospices have been very successful in reaching this goal.
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How well does hospice manage pain?
One of the basic goals of hospice is that patients will be comfortable and pain free. Hospice nurses are experts in pain and symptom management. They work closely with the patient, family and physician to assure optimal comfort by using medications, counseling and therapies.
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What if I need help after business hours or on weekends?
Hospice has hospice team members available 24 hours a day, 7 days a week, and 365 days a year to meet our patient’s needs. Patients and families need only to call us and our on-call staff will answer to address any problem or concern.
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What happens if the patient lives longer than six months? Will they be discharged?
No. Hospice patients are certified by the doctor for periods of care. Once a period of care ends, the doctor can recertify the individual for further hospice care if they are still eligible. For example, under Medicare, a patient can be certified for two ninety-day periods, followed by an unlimited number of sixty-day periods. As long as the doctor certifies that the person needs hospice care, he or she will continue to receive it.
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What if the patient improves?
Hospice patients do improve! A patient can sign out of hospice any time their condition improves or they decide to pursue aggressive, curative treatment. The hospice may discharge a patient if the condition improves such that the physicians do not feel the condition is likely to be terminal.
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What is respite in hospice?
For patients living at home, respite allows family caregivers to take a break from their care-giving responsibilities. The care is usually provided in a nursing home or inpatient hospice facility. Generally the family may receive up to five consecutive days for respite care.
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What does a hospice chaplain do?
Hospice is not affiliated with any particular faith tradition, but we recognize that facing death often brings up many spiritual questions for patients and families alike. The hospice chaplain can talk about those questions, link patients with clergy of their choice or just provide a spiritual presence in difficult times.
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What does a hospice volunteer do?
Hospice volunteers enhance the quality of life and help reduce the burden of care-giving. They are generally available to provide different types of support to patients and their loved ones including running errands, staying with a patient to give family members a break, and lending emotional support and companionship to patients and family members. Volunteers focus on what is important to the individual patient, perhaps reading, playing music, sharing memories or participating in a special hobby or activity.
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What happens when a patient dies?
The Hospice team will come when the patient dies and will handle the notification of family members, the patient’s physician, the funeral home and any local authorities that must be contacted. There is no need to contact emergency medical services, the police or any other service. We will be there to take care of these things as needed.
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Does hospice end when the patient dies?
No. Bereavement care provides continuing contact and support for survivors and caregivers for 13 months following the death of a loved one. Hospice also sponsors bereavement groups and support for anyone in the community who has experienced a death of a family member, a friend, or similar losses.
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What if I don’t have a private doctor?
Hospice has physicians available to care for patients who have no primary physician.
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How do I make a referral to hospice?
You may talk to the patient’s doctor and ask if a hospice referral can be made, or you can call Hospice and make the referral yourself. The hospice intake staff will contact the physician to verify appropriateness. Most appropriate patients are enrolled in the hospice program within 24 hours of the first call. Hospice is open 8am-5:00pm Monday-Friday and our staff are available on call 24 hours a day, 7 days a week, and 365 days a year.
We are available on-call 24 hours a day, seven days a week at (630) 233-5100.
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